Anti-Pentraxin 3 autoantibodies in systemic lupus erythematosus: A comparative study of patients with and without proteinuria

Maria Noor; Khursheed Javaid; Sana Mahmood; Ayesha Nadeem; Saima Pervaiz; Faheem Shahzad; Muhammad Kashif; Nadeem Afzal; Maria Noor; Khursheed Javaid; Sana Mahmood; Ayesha Nadeem; Saima Pervaiz; Faheem Shahzad; Muhammad Kashif; Nadeem Afzal

doi:10.3934/Allergy.2026015

AIMS Allergy and Immunology

2026, Volume 10, Issue 3: 209-221. doi: 10.3934/Allergy.2026015

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Research article

Anti-Pentraxin 3 autoantibodies in systemic lupus erythematosus: A comparative study of patients with and without proteinuria

1.
Rahbar Medical and Dental College, Lahore, Pakistan
2.
Institute of Allied Health sciences, University of Health Sciences Lahore, Pakistan
3.
University of Management and Technology (UMT) Lahore, Pakistan
4.
Akhtar Saeed Medical and Dental College, Lahore, Pakistan
5.
M. Islam Medical and Dental College, Gujranwala, Pakistan
6.
Bakhtawar Amin Medical and Dental College, Multan, Pakistan

Received: 13 January 2026 Revised: 13 September 2026 Accepted: 20 September 2026 Published: 28 September 2026

Background and objectives
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease frequently complicated by renal involvement, known as lupus nephritis (LN). Pentraxin 3 (PTX3) is an acute-phase protein implicated in immune regulation, and autoantibodies against PTX3 (anti-PTX3) have been hypothesized to exert a protective effect against the development of LN in SLE patients. The objective of the current study was to evaluate serum levels of anti-PTX3 IgG and anti-double-stranded DNA (anti-dsDNA) IgG antibodies in SLE patients and to assess their association with disease activity and proteinuria.
Methods
This cross-sectional study included 69 participants divided into three groups: SLE patients with proteinuria, SLE patients without proteinuria, and healthy controls. Serum IgG anti-PTX3 and anti-dsDNA levels were measured using enzyme-linked immunosorbent assay (ELISA). Proteinuria was assessed by measuring the albumin-to-creatinine ratio (A/Cr). Associations between antibody levels, proteinuria, and disease activity index were analyzed.
Results
Serum anti-PTX3 levels were highest in SLE patients without proteinuria, with a statistically significant difference among the three groups (p = 0.031). Anti-dsDNA antibodies were detected exclusively in SLE patients; however, no significant difference was observed between patients with and without proteinuria (p = 1.00). Anti-PTX3 levels demonstrated a weak negative correlation with A/Cr (r = −0.082) and with disease activity index (r = −0.142).
Conclusions
Higher anti-PTX3 levels in SLE patients without proteinuria and their inverse relationship with proteinuria and disease activity were observed in this cross-sectional sample; however, these correlations were weak and not statistically significant, and a protective or causal role cannot be established from these data. Anti-PTX3 may represent a candidate marker warranting longitudinal validation in patients with SLE.
- anti-dsDNA antibody,
- anti-PTX3,
- ELISA,
- lupus nephritis,
- proteinuria,
- systemic lupus erythematosus
Citation: Maria Noor, Khursheed Javaid, Sana Mahmood, Ayesha Nadeem, Saima Pervaiz, Faheem Shahzad, Muhammad Kashif, Nadeem Afzal. Anti-Pentraxin 3 autoantibodies in systemic lupus erythematosus: A comparative study of patients with and without proteinuria[J]. AIMS Allergy and Immunology, 2026, 10(3): 209-221. doi: 10.3934/Allergy.2026015

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Abstract

Background and objectives

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease frequently complicated by renal involvement, known as lupus nephritis (LN). Pentraxin 3 (PTX3) is an acute-phase protein implicated in immune regulation, and autoantibodies against PTX3 (anti-PTX3) have been hypothesized to exert a protective effect against the development of LN in SLE patients. The objective of the current study was to evaluate serum levels of anti-PTX3 IgG and anti-double-stranded DNA (anti-dsDNA) IgG antibodies in SLE patients and to assess their association with disease activity and proteinuria.

Methods

This cross-sectional study included 69 participants divided into three groups: SLE patients with proteinuria, SLE patients without proteinuria, and healthy controls. Serum IgG anti-PTX3 and anti-dsDNA levels were measured using enzyme-linked immunosorbent assay (ELISA). Proteinuria was assessed by measuring the albumin-to-creatinine ratio (A/Cr). Associations between antibody levels, proteinuria, and disease activity index were analyzed.

Results

Serum anti-PTX3 levels were highest in SLE patients without proteinuria, with a statistically significant difference among the three groups (p = 0.031). Anti-dsDNA antibodies were detected exclusively in SLE patients; however, no significant difference was observed between patients with and without proteinuria (p = 1.00). Anti-PTX3 levels demonstrated a weak negative correlation with A/Cr (r = −0.082) and with disease activity index (r = −0.142).

Conclusions

Higher anti-PTX3 levels in SLE patients without proteinuria and their inverse relationship with proteinuria and disease activity were observed in this cross-sectional sample; however, these correlations were weak and not statistically significant, and a protective or causal role cannot be established from these data. Anti-PTX3 may represent a candidate marker warranting longitudinal validation in patients with SLE.

Abbreviations

SLE

Systemic lupus erythematosus

Lupus nephritis

PTX3

Pentraxin 3

anti-PTX3

Anti-pentraxin 3 IgG autoantibody

anti-dsDNA

Anti-double-stranded DNA IgG antibody

ELISA

Enzyme-linked immunosorbent assay

A/Cr

Urinary albumin-to-creatinine ratio

ACR

American College of Rheumatology

SLICC

Systemic Lupus International Collaborating Clinics

SLEDAI-SELENA

Systemic Lupus Erythematosus Disease Activity Index—Safety of Estrogens in Lupus National Assessment

IQR

Interquartile range

Immune complex

Ads

Autoimmune diseases

SPSS

Statistical Package for the Social Sciences

Author contributions

Maria Noor: Study planning, synopsis preparation, data and sample collection, laboratory investigations, data analysis, interpretation of findings, manuscript drafting, revision, and finalization. Khursheed Javaid: Supervision, academic guidance, and critical review of the manuscript. Nadeem Afzal: Supervision, academic guidance, and critical review of the manuscript. Sana Mahmood: Sample collection, laboratory investigations. Ayesha Nadeem: Sample collection, laboratory investigations. Saima Pervaiz: Data collection, and data analysis. Faheem Shahzad: Study design, sample size calculation, and statistical analysis. Muhammad Kashif: Manuscript writing support and assistance with the publication process.

Conflicts of interest

The authors declare no conflict of interest.

Ethical approval

The study was approved by both the University of Health Sciences vide letter no UHS/REG-21/ERC/3923 (Dated 23 Aug 2021) and Sheikh Zayed Hospital Lahore vide letter noSZMC/IRB/External/M. Phil/369 /2021 (Dated 30 Sep 2021), Institutional Review Boards. All the patients provided written, informed consent for study participation and analysis of their data.

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